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DUE DATE: April 18, 2011															PRINT in BLUE or BLACK INK																																		DEPT USE ONLY																				101111100
	2010																								FORM
					INCOME TAX RETURN																		IN-111
					INCOME TAX RETURN
VERMONT																																																																											101111100
VERMONT

																											If filing jointly,																																																																		Check here if using
1		Taxpayer’s Social						-			-																Spouse or CU Partner																							-													-																														RECOMPUTED Federal
		Security Number						-			-																Social Security Number																							-													-																														Return information

		Taxpayer’s																																						First																																																														Initial
		Last Name																																						Name																																																														Initial
		Last Name																																						Name
Information		Spouse or																																						First
		Spouse or
		CU Partner																																																																																																				Initial
		CU Partner																																						Name																																																														Initial
		Last Name																																						Name
		Mailing Address
		Mailing Address
		(Number and Street/

Taxpayer		Road or PO Box)
		City/Town																																											State																					Zip																						-
		City/Town																																											State																					Code
																																																																		Code

			Check here if this						Check if														Check if Spouse
			Check here if this						Check if														Check if Spouse										1. VT School District Code 2.																												City/Town of Legal Residence on 12/31/2010																																										State
			is an AMENDED						taxpayer died														or CU Partner
			return						during 2010														died during 2010


2						FILING STATUS
2						FILING STATUS															7a							7b
	3			4			5		6																																																																																					8
Information																																																							Enter Spouse or CU Partner full name
																					Married							CU

		Single		Head of			Married				CU Partner																												Enter Spouse or CU																																																										Qualifying Widow(er)
		Single		Head of			Married				CU Partner										Filing							Filing											Enter Spouse or CU																																																										Qualifying Widow(er)
				Household			Filing				Filing										Filing							Filing											Partner Social																														-								-																				with dependent
				Household			Filing				Filing										Separately							Separately											Partner Social																																																										with dependent
							Jointly				Jointly										Separately							Separately																																																																					children
							Jointly				Jointly																												Security Number																																																										children

Filing		9. EXEMPTIONS CLAIMED (Federal Form 1040–Line 6d; 1040A–Line 6d; 1040EZ/1040NR-EZ–enter 0, 1, or 2)																																																							. .	.	. .		. .	.	.	.		.		. .	.			. .			.	.	.	.	.	.	.	.			.	. .	.	. .	.	.	.	. 9.
																																																																																												. 9.
																																																						Check to
Tax																																																						Check to																																																			0			0
	10.		ADJUSTED GROSS INCOME (Federal Form 1040–Line 37; 1040A–Line 21; 1040EZ–Line 4)																																																			indicate loss															10.														,											,						.


3																																																						Check to
	11.		FEDERAL TAXABLE INCOME						(Federal Form 1040–Line 43; 1040A–Line 27; 1040EZ–Line 6)																																													indicate loss																																																			0			0
			If the Federal amount is zero, see instructions on page 8																																																			indicate loss															11.														,											,						.
																											. . .	.	. . .	. .	.	.		. . .			.	. .	. . .		. .		.


		ADDITIONS:
		ADDITIONS:																																																																																																							0			0
		12a. Income from Non-VT State and Local Obligations (Schedule IN-112, VT Calculation A, Part I, Line 3)																																																						.	.	.		. .		.		12a.															,											,									.						0			0

		12b.	50% Bonus Depreciation allowed under Small Business Jobs Act of 2010. . . .																																. . .			.	. .	. . .		. .		.																										12b.													,											,						.					0			0
																																																						If negative,
																																																						If negative,																																																				0		0
Income		12c.	Add Back of State and Local Income Taxes (Schedule IN-154, Line 10)																																																			check here																12c.															,											,						.				0		0
																																		. . .			.	. .	. . .	.	. .		.

																																																						Check to
																																																						Check to																																																			0			0
	13.		FEDERAL TAXABLE INCOME WITH ADDITIONS (Add Lines 11, 12a, 12b. and 12c)																																				. .	. . .	.	. .		.										indicate loss															13.															,											,						.				0			0
	13.																																																																				13.															,											,						.
Taxable
		SUBTRACTIONS:																																																																																																							0			0
		14a. Interest Income from U.S. Obligations																							. . .	. . . .		. . .	.	. . .	. . .		.		. . .	.		.	. .	. . .	.	.	.	.		.	.		.	.				.	.				.	. .		.	.	.		. .		.		14a.													,											,						.					0			0

		14b. Capital Gains Exclusion (From Schedule IN-153) . . . .																				.	. .		. . .	. . . .		. . .	.	. . .	. . .		.		. . .	.		.	. .	. . .	.	.	. .			.	.		.	.				.	.				.	. .		.	.	.		. .	.			14b.													,											,						.					0			0

		14c. Adjustment for 2008 & 2009 Bonus Depreciation																			.	.	.	.	. . .	. . . .		. . .	.	. . .	. .	.	.		. . .	.		.	. .	. . .	.	. .		.		.			.	.				.	.	.			.	. .	.	.	.			. .		.		14c.													,											,						.					0			0

		14d.	Add Lines 14a, 14b, and 14c . . . .							.	. .	.	.	. .	. . . .	. . .	.	.	.	.	.	.	. .		. . .	. . . .		. . .	.	. . .	. . .		.		. . .	.		.	. .	. . .	.	.	. .			.	.		.	.				.	.				.	. .		.	.	.		. .	.			14d.													,											,						.					0			0

	15.		VT TAXABLE INCOME (Subtract Line 14d from Line 13. If Line 14d is more than Line 13, enter zero.)																																																					.		. .			.	.	.	15..															,											,								.				0		0

4		16. VT INCOME TAX FROM VT TAX TABLE OR TAX RATE SCHEDULE on Line 15 amount																																																																			16.														,											,						.					0			0
																																																				.	.				.	. .	.		. .			.	.	.			16.														,											,						.					0			0

		17. ADDITIONS TO VT INCOME TAX (Schedule IN-112, VT Calculation A, Part II, Line 10)																																																	.			.	.		.		.	. .	.		. .		.	.	.		17..														,											,						.					0			0

Tax		18. VT INCOME TAX WITH ADDITIONS (Add Lines 16 & 17)																										. . .	.	. . .	. .	.	.		. . .		.	.	. .	. . .		. .		.		.			.	.				.	.				.	. .	.		. .			.	.	.	18..														,											,						.					0			0
Tax
VT Income		19. SUBTRACTIONS FROM VT INCOME TAX (Schedule IN-112, VT Calculation A, Part II, Line 18). . . .																																																				.	.				.	. .	.		. .			.	.	.	19..														,											,						.					0			0

	20.		VT INCOME TAX (Subtract Line 19 from Line 18) If Line 19 is more than Line 18, enter zero																																																			.	.	.			.	. .		.	.	.		. .		.	20..														,											,						.					0			0
	20.																																																																				20..														,											,						.							%
		. . . . . . . . . .21. INCOME ADJUSTMENT (Schedule IN-113, Line 43 OR 100.00%)																																.	. . .		.	.	. .	. . .		. . .			.		.	.		. .	.			.	.		.		.	. .	.		. .		.	.	.		.		.	. .	.	. .	. . . . . . . . . . . . ..21.																							.									%

	22.		ADJUSTED VT INCOME TAX (Multiply Line 20 by Line 21)																									. . .	.	. . .	. .	.	.		. . .	.		.	. .	. . .	.	.	.	.		.	.		.	.				.	.	.			.	. .		.	.	.		. .		.	22..														,											,						.					0			0

Continued on back ☛

Form IN-111

Enter amount from Line 22 ______________________________

*101111200*

5
5											0	0	+ 24.																						0		0			= 25.							0	0
	23.			,			,			.	0	0	+ 24.											,				,					.		0		0			= 25.				,	,	.	0	0
Tax		CREDIT FOR INCOME TAX PAID TO OTHER															VT TAX CREDITS (Schedule IN-112,																										TOTAL VT CREDITS
Tax		STATE OR CANADIAN PROVINCE															VT Calculation D, Line 5 OR Schedule IN-119)																										(Add Lines 23 and 24)
Use		STATE OR CANADIAN PROVINCE															VT Calculation D, Line 5 OR Schedule IN-119)																										(Add Lines 23 and 24)
		(Schedule IN-112, VT Calculation B, Line 6)
		(Schedule IN-112, VT Calculation B, Line 6)																																													0	0
and	26.	VT INCOME TAX AFTER CREDITS (Subtract Line 25 from Line 22. If Line 25 is more than Line 22, enter zero.) . . .																																						. . 26				,	,	.	0	0
and	26.																																							. . 26				,	,	.
Credits	27.	USE TAX (See page 9 for instructions and chart)												. . .	. . .	.	. . .		. . .	. . .		.		. .	. . .	. . .	. . .	. . .	. . .	. . .		. . .	. . .	.	. .	.	. .	.		. . . 27				,	,	.	0	0

	28.	TOTAL VT TAXES (Add Lines 26 and 27)																																					.	. . 28.				,	,	.	0	0
	28.	TOTAL VT TAXES (Add Lines 26 and 27)											. . . .	. . .	.	. .	.	. .	.		. .	. . .	. . .	. . .	. . .	. . .	. . .	. . .		. . .	.	. .	.	. .	.					. . 28.				,	,	.	0	0

6		Nongame Wildlife Fund										Children’s Trust Fund																		VT Veterans’ Fund
Contributions		Nongame Wildlife Fund										Children’s Trust Fund																		VT Veterans’ Fund

	29a.		,		.	0		0	+	29b.			,				.	0		0			+					29c.				,								.	0	0	=	29d.	,	.	0	0

	30. TOTAL OF VT TAXES & VOLUNTARY CONTRIBUTIONS (Add Line 28 and Line 29d)																												. . .	. . .	.	. .	. . .	.	. .	.	. .	.	.	. . 30				,	,	.	0	0
																																								. . 30				,	,	.

7
7			31a. VT Tax Withheld (Attach state copy of W-2, 1099, etc.)							31a.						,							,									.			0			0
																																			0			0

			31b. 2010 Estimated Tax or Extension Payments							31b.						,							,									.			0			0

Credits			31c.	Earned Income Tax Credit (Schedule IN-112, VT Calculation C)						31c.													,									.			0			0

			31d.	Renter Rebate (Form PR-141, Line 9)						31d.														,									.			0		0
and																																				0		0

																																					0		0
Payments			31e. VT Real Estate Withholding (See instructions on page 10)							31e.						,								,									.				0		0
			31f. Business Entity Payments for Nonresident Partner,
			31f. Business Entity Payments for Nonresident Partner,																												.				0			0
				Member, or Shareholder (Form WH-435, see page 10)						31f.						,						,													0			0
				Member, or Shareholder (Form WH-435, see page 10)						31f.						,						,
			31g. Low Income Child & Dependent Care Credit
			31g. Low Income Child & Dependent Care Credit							31g.																							.			0		0
				(See instructions on page 10)																				,									.			0		0
		31h.	TOTAL PAYMENTS AND CREDITS (Add Lines 31a through 31g)							31g.				. . . . .	.	. .			. . .			. . .	. . .	. . .	.			. .		. . .	. . .	.	. .	.		. . .				. . 31h.		,	,			.	0	0
8
8		32.	OVERPAYMENT If Line 30 is less than Line 31h, subtract Line 30 from Line 31h																																32.						,	,	.	0	0
		32.													. . .			. . .	. . .	. . .			.	. .		. . .	. . .	.	. .	.			. . .		32.						,	,	.	0	0
		33a. REFUND TO BE CREDITED TO 2011 ESTIMATED TAX PAYMENT
Refund		33a. REFUND TO BE CREDITED TO 2011 ESTIMATED TAX PAYMENT								33a.
			Amount on 31d cannot be credited to 2011 estimated tax payment							33a.							,							,									.

		33b. REFUND TO BE CREDITED TO 2011 PROPERTY TAX BILL								33b.						,								,									.			0			0


	34.		. . . . . . . . . .REFUND AMOUNT (Subtract Lines 33a and 33b from Line 32)							. . . . .	.	. .	.		. . .			. . .	. . .	. . .	.			. .		. . .	. . .	.	. .	.			. . .		. . . 34.						,	,	.	0	0

9
9																																												0	0
Due	35.		If Line 30 is more than Line 31h, subtract Line 31h from Line 30. See page 11 for instructions on tax due.. . . . . . . . . . . . . . . . . . 35.																																						,	,	.	0	0
									Interest and Penalty on Underpayment of
	36.				,	.	0	0	Interest and Penalty on Underpayment of										37. Add Lines 35 and 36 . 37.																							,	.	0	0
				,					Estimated Tax (Worksheet IN-152 or 152A)																																,
				,					Estimated Tax (Worksheet IN-152 or 152A)																																,
For amended				Original refund received ________________ Refund due now __________________																Original payment_________________																					Amount due now _______________
returns only																				Original payment_________________																					Amount due now _______________

10 Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge

and belief, they are true, correct and complete. Preparers cannot use return information for purposes other than preparing returns.

Signature

Date

Occupation

Check if age

Telephone Number (optional)

65 or older

Signatures

Signature. If a joint return, BOTH must sign.

Date

Occupation

Check here if authorizing the VT Department of Taxes to discuss this return and attachments with your preparer.

Preparer’s signature

Date

Preparer’s

SSN or

PTIN

Use Only

Firm’s name (or yours if self-employed) and address

EIN

Preparer’s Telephone Number

Form IN-111

Keep a copy for your records.

Question	Answer
Form Name	Form In 111
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	33b, 14c, 2010, 31h

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